Eating Disorder Recovery Los Angeles
You've been stuck in a cycle of restricting or bingeing and purging followed by intense guilt. Or alternatively, maybe you're having trouble with food textures to the point that you're struggling to find anything that feels safe to eat. It feels impossible to do things that feel so simple and enjoyable for others, like going out to brunch with friends or attending family dinners. You want to get to the point where you're "recovered" and no longer constantly thinking about food, exercise, and weight, but it feels out of reach. Your eating disorder gives you a sense of safety and control that you haven't found in anything else.
How do I recover from an eating disorder, and what does treatment look like?
Recovery from an eating disorder is a process that is unique to each person, though there are some common features in many people's journey to recovery that can be used to guide treatment. As a licensed therapist specialized in eating disorders, I help people move toward recovery by first identifying current eating disorder behaviors and what their function is; what are these behaviors protecting the person from or offering them safety from? For example, for some, eating disorders offer a sense of control amongst a chaotic and unpredictable family life, or for others, disordered eating habits might arise out of society's lack of accommodation for their needs as a neurodivergent person. I help clients understand the function of their eating disorder primarily through Internal Family Systems (IFS), a type of therapy designed to identify protective parts, separate the eating disorder from the person's sense of self and identity, and allow the person's sense of self to take the driver's seat again. I also work with clients to look at the influence of other systems on their eating disorder. For example, is transphobia, racism, or fatphobia in conjunction with diet culture encouraging them to engage in disordered eating in search of safety from these systems? Once we understand the function of the eating disorder and what needs of ours it's addressing, we can begin to find other ways to meet those needs. I often pull from Dialectical Behavioral Therapy (DBT) and other modalities to help people with eating disorders develop alternative ways of coping and meeting their needs.
I provide treatment at the outpatient level of care, meaning I typically see the clients I work with weekly or biweekly for one hour, and I also often recommend the clients I work with see an eating disorder registered dietitian (RD) weekly as well. If more support is beyond a couple hours a week is needed, a partial hospitalization (PHP) / intensive outpatient program (IOP) may be recommended. PHP/IOP programs typically require clients to be present 3-8 hours per day for five to six days a week. For further support beyond that where medical supervision may be necessary, care may advance to the residential or hospital level for round the clock care. Accommodations are often made in these higher levels of care for tweens and teens to continue their schooling, and for working adults, a leave of absence from work may be indicated. I am connected with various PHP/IOP and residential programs in Los Angeles and help clients decide if and when they may need higher levels of care.
What informs my approach to eating disorders?
My name is Gabby Collins, LCSW (she/they) and there are several philosophies or approaches that I think are important to my understanding of and approach to eating disorders:
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Health at Every Size (HAES) - I believe that weight and BMI alone are not often good indicators of health, and that our society at large, and thus, our healthcare systems, are riddled with fatphobia and anti-fat bias. Health and fatness are not mutually exclusive.
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Moralization of Health - Health has also been moralized in our society, meaning that being "healthy" and striving for health make someone a "good" person, and if you don't make the socially sanctioned "healthy" choice every time, you must be "bad". This creates guilt around choices that bring us joy, like enjoying a dessert, and this guilt is compounded if we also exist in a larger or fat body.
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We Cannot Ignore Systems - Fatphobia is borne out of white supremacy and racism, and these systems are connected to homophobia, transphobia, ableism, and other "-isms". It is not possible to check these systems at the door of the therapy room, especially in eating disorder work; these systems and their influences must be examined in therapy.
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Diet Culture - Our society, due to its fatphobia, encourages weight loss by any means necessary. It encourages habits that are counterintuitive to its healthism, including severly restrictive diets that are not sustainable. I do not encourage intentional weight loss in my work with clients. This does not mean I don't work with people on a weight loss journey or people who are still engaging in restrictive eating disorder behaviors, it simply means I work with the person to continue to examine their motivations for weight loss and if the weight loss is serving their long-term goals and values .
